Sinus Computed Tomographic Findings in Adult Smoking and Non-Smoking Asthmatics: Analysis of Clinical Indices and Biomarkers.

Sinus Computed Tomographic Findings in Adult Smoking and Non-Smoking Asthmatics: Analysis of Clinical Indices and Biomarkers.

Ann Am Thorac Soc. 2016 Dec 28;:

Authors: Kimura H, Konno S, Nakamaru Y, Makita H, Taniguchi N, Shimizu K, Suzuki M, Ono J, Ohta S, Izuhara K, Nishimura M, Hi-CARAT investigators

Abstract
RATIONALE: When the two conditions occur together, sinusitis and asthma are often thought to represent anatomically separate components of the same chronic inflammatory airway disease. Information about the effect of smoking on the interaction between sinusitis and asthma in patients who have both disorders is limited.
OBJECTIVES: This study aimed to evaluate the effect of cigarette smoking on the relationship between the presence and severity of sinusitis and selected asthma-related indices in adults who have asthma.
METHODS: This study included 127 patients with severe asthma and 79 patients with mild-to-moderate asthma. Clinical data were obtained from all subjects during a two-day stay in Hokkaido University Hospital (Sapporo, Japan). The Lund-Mackay scoring system was used to assess the anatomic extent and severity of sinusitis as revealed by sinus computed tomographic (CT) images obtained during the hospitalization. We examined associations between Lund-Mackey scores and a variety of asthma-related indices and levels of biomarkers in blood and sputum. To clarify the effect of smoking on these associations, we conducted separate analyses for non-smoking (<10 pack years, N = 130) and smoking subjects (≥10 pack years, N = 76).
MEASUREMENTS AND MAIN RESULTS: In our cohort of adults with asthma, we found significant positive relationships between the presence and severity of sinusitis as assessed by Lund-Mackay score and the severity of asthma as measured by percent predicted FEV1 or FEV1/FVC for non-smoking subjects (<10 pack years) but not for cigarette smokers (>10 pack years). Lund-Mackay scores correlated with blood and sputum eosinophil counts, serum IgE levels, and fractional exhaled nitric oxide, regardless of smoking status. Lund-Mackay scores also showed significant positive associations with serum periostin and chemokine C-C motif ligand 18 levels, regardless of smoking status; whereas a positive association with plasma osteopontin level was seen only for non-smoking subjects.
CONCLUSION: We found as association between the severity of sinusitis on CT imaging and theseverity of concomitant asthma on spirometry for non-smoking adults but not for smokers. In adults with asthma, CT imaging evidence of severe sinusitis indicates intense Th2-related inflammation regardless of smoking status.

PMID: 28029801 [PubMed - as supplied by publisher]

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